HIV/AIDS Bureau
Division of State HIV/AIDS Programs (DSHAP)
Ryan White Part B
Technical Assistance Webinar
FY 2013 Ryan White Part B Supplemental
Funding Opportunity Announcement (FOA)
and the FY 2013 ADAP Emergency Relief
Funding (ERF) FOA
June 26, 2013
HAB DSHAP Mission
To provide leadership and support to
States/Territories for developing and
ensuring access to quality HIV
prevention, health care, and support
services.
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Agenda
Opening Remarks/ Announcements
Heather Hauck
Question and Answer
Part B Supplemental FOA
Harold Phillips
Questions and Answer
ADAP ERF FOA
Heather Hauck
Questions and Answer
Closing Remarks
Heather Hauck
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Presenters
Harold Phillips
Deputy Director, Division of State HIV/AIDS
Programs
Heather Hauck
Director, Division of State HIV/AIDS Programs
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Objectives
•
To discuss the FY 2013 Ryan White States/Territories
Part B Supplemental FOA and ADAP ERF FOA
•
Provide pre-application Technical Assistance (TA) to
Part B grantees
•
Part B Supplemental X08 FOA due - July 15th
•
FY 2013 ADAP ERF X09 FOA due – July 19th
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Announcements
Heather Hauck, Director
Division of State HIV/AIDS Programs
HIV/AIDS Bureau
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Questions
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Ryan White States/Territories Part B
Supplemental FOA
New - Limited Competition
Announcement Number: HRSA-13-161
Harold Phillips, MRP
Deputy Director, Division of State HIV/AIDS Programs
HIV/AIDS Bureau
Health Resources and Services Administration
Department of Health and Human Services
Purpose of RW Part B Supplemental
• Solicits applications for the Ryan White HIV/AIDS
Program Part B Supplemental program.
• Supplement the services otherwise provided by the
State.
• Determined by the applicant’s ability to demonstrate
the need in the State based on an objective and
quantified basis.
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Ryan White States/Territories Part B
Supplemental
Summary of Funding
• Approximately $15,433,994 is expected
to be available for 2013 Part B
Supplemental funding, of which up to
approximately $4,534,654 will be used
for priority funding.
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Ryan White States/Territories Part B
Supplemental
• The State/Territory must demonstrate the
severity of the HIV/AIDS epidemic in the
State/Territory by using:
• Quantifiable data on HIV epidemiology, comorbidities, cost of care, the service needs of
emerging populations, unmet need for core medical
services, and unique service delivery challenges.
• Applicants should explain why supplemental funding
for health services is needed to provide necessary
services for people living with HIV and AIDS in the
State/Territory.
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RW Part B Supplemental
Demonstrated Need
• Factors in assessing demonstrated need:
• The unmet need for HIV-related services as
determined by section 2617(b) of the PHS Act;
• An increasing need for HIV/AIDS-related services,
including relative rates of increase in the number of
living cases of HIV/AIDS;
• The relative rates of increase in the number of living
cases of HIV/AIDS within new or emerging
subpopulations;
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RW Part B Supplemental
Demonstrated Need
• The current prevalence of HIV/AIDS;
• Relevant factors related to the cost and complexity
of delivering health care to individuals with
HIV/AIDS in the eligible area;
• The impact of co-morbid factors, including cooccurring conditions including high rates of sexually
transmitted infections (STIs), Hepatitis,
Tuberculosis, substance use, severe mental illness,
and other co-morbid factors;
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RW Part B Supplemental
Demonstrated Need
• The prevalence of homelessness;
• The prevalence of individuals who were released from
federal, state or local prisons during the preceding
three years and had HIV/AIDS on the date of their
release;
• Relevant factors that limit access to health care
including geographic variation, adequacy of health
insurance coverage and language barriers; and
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RW Part B Supplemental
Demonstrated Need
• Impact of a decline in the amount received in formula
funding on services available to all individuals with
HIV/AIDS identified and eligible under the title.
• Applicants should document the use of multiple data
sets, such as HIV/AIDS epidemiologic data, comorbidity data, poverty and insurance status data,
current utilization data and assessments of emerging
populations with special needs.
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New to this Year’s Application
• 2013 Part B Supplemental FOA does not request
Epidemiology Data, as the information was provided in
the Ryan White HIV/AIDS Program Part B (HRSA-13158) FOA.
• 2013 Part B Supplemental FOA does not request Unmet
Need data, as the information was provided in the Ryan
White HIV/AIDS Program Part B (HRSA-13-158) FOA.
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New to this Year’s Application
• The “Justification for Ryan White Part B
Supplemental Funding” which appeared in
last year’s Part B Supplemental FOA has
been removed from this application and
those Review Criteria points have been
redistributed among the remaining sections.
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Additional Information
• Part B Supplemental funding may be used to
support the strategy, plan and data collection
as it relates to how the State/Territory will
identify individuals living with HIV/AIDS who
are unaware of their status (EIIHA).
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Additional Information
• For States/Territories with current or potential shortfalls
in ADAP resources, HAB strongly encourages grantees
to prioritize Part B Supplemental funds to augment
ADAP program resources when the following exist:
•
•
•
•
•
ADAP Waiting Lists
Capped Enrollment
Reductions in ADAP formulary
Reduction in Percentage of FPL Eligibility
Other ADAP Program Restrictions within the jurisdiction
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Priority Funding Provision
• $4,534,654 will be used for priority funding
• Section 2620(c) of the PHS Act: The Amount of
Supplemental Funds Disbursed to States under RW
Part B to Address Service Decline or Disruption of
Services Due to Reductions in Formula Grant
Amounts
• Such a decline in funding compares the amount
received in fiscal year 2013 to the amount received
in fiscal year 2006, and a State’s assertion that such
decline has had an impact on services available
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Scoring of Applications
• Objective Review Committee (ORC) scores will
be used to establish the rank order for the
awarding of funds.
• Once the applications have been ranked by the
ORC, award amounts are determined on a
formula based on the ORC score and the
grantee’s number of living HIV/AIDS cases.
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Caps on Expenses
• Part B grantee administrative costs may not exceed
10% of the total Part B grant award including the
Part B Supplemental.
• Planning and Evaluation costs may not exceed
10% of the total Part B grant award. Collectively,
Grantee Administration, and Planning and
Evaluation may not exceed 15% of the total Part B
award.
• Part B Clinical Quality Management costs may not
exceed 5% of the total Part B grant award or
$3,000,000 (whichever is the lesser amount).
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Who Can Apply?
• 53 States/Territories are eligible to apply.
• Any State or Territory that had more than 5 percent of
their FY 2011 formula funds cancelled under sections
2618(a)(1) or 2618(a)(2)(F)(i), offset under section
2622 (e), or covered by any waivers under section
2622(c) for fiscal year 2011 are not eligible
• Therefore the following States/Territories are not
eligible to apply to this FOA this year – American
Samoa, Guam, Marshall Islands, Mariana Islands,
Palau, Rhode Island
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Application and Submission
• Applicants are required to apply electronically through
Grants.gov
• The Central Contractor Registration (CCR) transitioned
to the System for Award Management (SAM) July 30,
2012. (To learn more about SAM, please visit
https://www.sam.gov.)
• SAM Quick Guide for Grantees
(https://www.sam.gov/sam/transcript/SAM_Quick_Guid
e_Grants_Registrations-v1.6.pdf), an entity’s
registration will become active after 3-5 days. Check
for active registration well before the application
deadline.
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Application and Submission
• All applicants are responsible for reading the
instructions included in HRSA’s Electronic
Submission User Guide, available online at
http://www.hrsa.gov/grants/apply/userguide.pdf
• Applicants are also responsible for reading the
Grants.gov Applicant User Guide, available online at
http://www.grants.gov/assets/ApplicantUserGuide.pdf
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Application and Submission
• Applicants must submit proposals according to the
instructions in the Guide and in this FOA in
conjunction with Application Form SF-424. The forms
contain additional general information and
instructions for applications, proposal narratives, and
budgets. The forms and instructions may be obtained
by:
• 1) Downloading from http://www.grants.gov, or
• 2) Contacting the HRSA Digital Services
Operation (DSO) at: [email protected]
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Application Format Requirements
• The total size of all uploaded files may not exceed
the equivalent of 40 pages when printed by HRSA.
The total file size may not exceed 10 MB. The 40page limit includes the abstract, project and budget
narratives, attachments, and letters of commitment
and support. Standard forms are NOT included in the
page limit.
• Applications must be submitted prior to the deadline
to be considered under this announcement.
• See pages 7-8 for table of contents and order of
documents and attachments.
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Agency Contacts
• Program issues and/or technical assistance regarding
this funding announcement may be obtained by
contacting:
Heather Hauck, Tel: 301-443-6547
Fax: 301-443-8143, Email: [email protected]
• Business, administrative, or fiscal issues related to this
funding opportunity announcement by contacting:
Karen Mayo Telephone: (301) 443-3555
Fax: (301) 594-4073 E-mail: [email protected]
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Agency Contacts
• Applicants may need assistance when
working online to submit their application
forms electronically. Applicants should
always obtain a case number when calling
for support.
• For assistance withGrants.gov Contact
Center Telephone: 1-800-518-4726 E-mail:
[email protected]
iPortal: http://grants.gov/iportal
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Questions
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Ryan White PART B
AIDS Drug Assistance Program (ADAP)
Emergency Relief Awards
New & Competing Continuation Grants
Announcement Number: HRSA 13-202
Heather Hauck, MSW, LICSW
Director, Division of State HIV/AIDS Programs
HIV/AIDS Bureau
Health Resources and Services Administration
Department of Health and Human Services
Objectives
• Assist eligible applicants in preparing FY
2013 ADAP ERF application
• Explain Limited New and Competing
Continuation ADAP Emergency Relief
Funds
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Overview of FY 2013 ADAP ERF
• Eligible Competing Continuation applicants are
current FY 2012 ADAP ERF grantees.
• There are two awards available within this single
FOA: Limited New Competition and Competing
Continuation
• Limited New Competitive applicants are states that
have instituted new waitlists since the date of
issuance of the last ADAP ERF FOA on May 2,
2012 to April 30, 2013, and States that have
implemented a waiting list as of January 1, 2013.
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Overview FY 2013 Part B ADAP ERF
• ADAP Wait List
o A waiting list is a strategy used when adequate
funding is not available to provide medications to all
eligible persons requesting enrollment in the state
ADAP after implementing all other feasible costeffectiveness strategies (e.g., lowering federal
poverty level [FPL], reducing formulary, capping
costs, etc.)
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Summary of ADAP ERF Funding
• In FY 2013, it is anticipated that $10 million will be
available in ADAP ERF limited new competition funds to
fund up to10 grantees with a ceiling of $3 million.
• $65 million in competing continuation grants is available
to fund approximately 25 grantees with a ceiling amount
of their total FY 2012 ADAP ERF award.
• Any FY 2013 appropriated ADAP ERF funds not awarded
under the Limited New Competition section of the FOA
will be made available as needed to existing ADAP ERF
grantees as continuation grants.
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ADAP ERF Award Information
• The Amount of Each Award Will Be Based
On:
• The applicant’s ability to demonstrate need for
funding to prevent, eliminate or reduce waiting list
and/or implement “cost-cutting” measures and/or
“cost saving” measures and
• The success of the applicant’s past efforts to
improve the cost-effectiveness of ADAP
operations consistent with HRSA
recommendations and policies and to maximize
available resources.
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Use of ADAP ERF Funds
• ADAP Wait List
• Cost Containment Measures
• Cost-cutting measures
• Cost-saving measures
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Use of ADAP ERF Funds
• States with existing waiting lists as of
January 1, 2013 must use all ADAP ERF
Limited New Competing funds to address
the waiting list.
• States without a waiting list reported to
HRSA as of January 1, 2013 must use all
ADAP ERF limited New Competing funds
to address “cost-cutting” measures and/or
support implementation of “cost saving”
measures during the project period to
prevent a waiting list.
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Cost -Saving Measures
• Any measure taken to improve the costeffectiveness of ADAP operations, which
are required to achieve, improve and/or
maximize HRSA recommended cost-saving
strategies that all States should be working
to achieve and/or maximize regardless of
financial status.
• States may request emergency ADAP
emergency relief funding to implement
“cost-saving measures”
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Cost -Cutting Measures
• ADAP ERF funding may be requested to
address/reverse (completely or partially) “costcutting” measures.
• Restrict/reduce enrollment (e.g. reduction of financial
eligibility below 300 percent of the Federal Poverty Level
(FPL), capped enrollment)
• Reduce benefits (e.g. formulary reductions with respect to
antiretroviral and medications to treat opportunistic
infections or complications of HIV)
• Instituted out of necessity due to insufficient resources
and/or to avoid starting a waiting list.
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Limited New Competing Applicants
• Limited New Competing applicants are states that have
instituted new waitlists since the date of issuance of the last
ADAP ERF FOA on May 2, 2012 to April 30, 2013, and States
that have implemented a waiting list as of January 1, 2013.
• States with an ADAP waiting list reported to HRSA as of
January 1, 2013 must use all funding awarded under this
announcement to remove clients from the waiting list.
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Limited New Competing Applicants
• States that did not report a waiting list to HRSA
as of January 1, 2013, must use funding
awarded under this announcement to address
“cost-cutting” measures (e.g. reduction in ADAP
eligibility below 300% FPL and/or the formulary
with respect to antiretrovirals and drugs to treat
opportunistic infections or HIV/AIDS
complications) and/or support the
implementation of “cost-saving” measures
during the project period to prevent a waiting
list.
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Limited New Competing Applicants
• The amount of each award will be based on
• Applicant’s ability to demonstrate need for funding to
address a waiting list and/or “cost-cutting” measures
and/or “cost-saving” measure
• Success of the applicant’s past efforts to improve the
cost-effectiveness of ADAP operations consistent with
HRSA recommendations
• Policies to maximize available resources.
• Determination will be made by Objective Review
Committee (ORC)
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Limited New Competing Applicants
• Funding will be based on the applicant’s responses to
addressing the waiting lists as follows:
• The ORC scores will be used to establish the rank order
for the awarding of funds.
• All applicants that request new limited competitive ADAP
ERF funds to address waiting lists and are recommended
for an award by the ORC will receive awards based on
their ORC scores.
• Applicants that request funds for “cost-cutting” measures
and/or “cost saving” measures will receive awards based
on their ORC scores.
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Limited New Competing Applicants
Eligibility Information
• The following States and Territories are NOT
eligible to apply for funding under the Limited
New Competition:
• AL, AK, AZ, CA, CO, FL, GA, ID, IL, IA, KY,
LA, MT, NE, NJ, NC, ND, PR, SD, TN, UT, VI,
VA, WA, and WI.
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ADAP ERF Competing Continuation
• This FOA also contains instructions for FY 2013 ADAP ERF
Competing Continuation applications for the grantees that
received FY 2012 ADAP ERF, to the extent that additional
funds are needed and justified.
• Applicants for Competing Continuation awards must
document how FY 2012 ADAP ERF dollars have been used
to reduce their waiting list and/or address “cost-cutting”
measures and/or implement “cost-saving” measures.
• This includes the number of clients removed from the State’s
2012 - 2013 ADAP waiting list and/or otherwise impacted by the
implementation of cost containment measures implemented
after September 20, 2012.
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ADAP ERF Competing Continuation
• A total of $65 million is available for FY 2013
Competing Continuation awards. Applicants are
advised that the awards will be capped at the
applicant’s total FY 2012 ADAP ERF award
amount.
• A Competing Continuation award is not
guaranteed, but rather will be determined by the
applicant’s documentation and justification of
the need for continuation funds, with priority
given to addressing waiting lists.
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ADAP ERF Competing Continuation
• Competing continuation awards are intended
to:
• Prevent, reduce and/ or eliminate ADAP waiting lists
• Address “cost-cutting” measures initiated after
September 30, 2012
• Complete the implementation of “cost saving”
measures initiated after September 30, 2012.
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ADAP ERF Competing Continuation
• Grants are intended to provide support to Ryan White
Part B grantees that received FY 2012 ERF
• Grantee provide justification for additional funding
• $65 Million is available for FY 2013 competing
continuation awards
• Funds will be awarded on a needs-based formula
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ADAP ERF Competing Continuation
• Will be capped at the applicant’s FY 2012
ADAP ERF award amount;
• Applicants are to calculate and request funds
for a 12 month budget period
• Funds are not guaranteed, and determined
by the applicant’s documentation and
justification of the need for continuation funds
for the 6-month project and budget period
(September 30, 2012 – March 31, 2014).
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ADAP ERF Competing Continuation
• Only the following 25 Part B grantees that
received FY 2012 ADAP ERF awards are
eligible to apply for FY 2013 Competing
Continuation ADAP ERF awards:
• AL, AK, AZ, CA, CO, FL, GA, ID IL, IA,
KY, LA, MT, NE, NJ, NC, ND, PR, SD,
TN, UT, VI, VA, WA, and WI.
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Scoring of Competing Continuation
Applications
• Funding will be based on the Objective Review
Committee’s (ORC) review and scoring of applicant’s
responses to the criteria published in this
announcement with priority given to addressing waiting
lists as follows:
• The ORC scores will be used to establish the rank order for the
awarding of funds.
• All applicants that request competing continuation ADAP ERF
funds to prevent, eliminate or reduce waiting lists and are
recommended for an award by the ORC will receive awards first
based on their ORC scores.
• Once those funds are distributed, then applicants that request
funds for cost-containment (“cost-cutting” measures and/or
“cost saving” measures) will receive awards.
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Scoring of Competing Continuation
Applications
• Applicants with the highest scores will be funded at the full
amount requested as long as the amount requested is for
allowable services under this FOA, and recommended by the
ORC, falls within the minimum and maximum amount available,
and there are still funds available to distribute.
• The FOA also identifies reports and other forms of documentation
that will be required from all applicants for funds under this
announcement. Applicants are advised that all FY 2013 ADAP
ERF awards will be for a 6-month project and budget period
(September 30, 2013 to March 31, 2014).
• All applicants must submit their application electronically through
Grants.gov. Applicants may utilize information previously
submitted in their FY 2013 Part B application (HRSA-13-158)
where applicable.
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FY 2013 ADAP ERF
The Sample format for the ADAP Profile
can be found at
http://hab.hrsa.gov/adapprofile
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Questions
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